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Invasion of the Body Snatchers

My jaw already dropped over this story several days ago when I first learned of it. I've only been waiting to post it until the Islam series was fully launched, because it is on a completely different topic.

I still find this hard to believe, but here it is in cold, hard pixels:

Manhattan is going to start a federally funded pilot program intended to procure more kidneys for transplant. Here's how it will work: The people running the program will monitor 911 calls and dispatch chatter via radio. They will discover from this when someone has collapsed and is in danger of death from apparent or possible heart failure. If an EMT arrives and declares the person dead, the procurement team will rush to the scene where they will have a brief window of time (fifty minutes from declaration of death) to obtain confirmation that the suddenly dead person is on a donor registry and to obtain consent from relatives who happen to be present. The story is unclear as to whether family consent is sufficient even if the person is not on an organ donation registry. (If the person is already on a donation registry, would family consent be necessary?) After getting the required paperwork, the (very new) body will be put into a special ambulance and hooked up to a machine to keep it oxygenated, then rushed to a hospital where the kidneys will be taken.

Oh, and somewhere in that narrow window of time they will also fit a lightning-quick evaluation by a police detective to make sure that there is not going to be a criminal investigation for which the body might be needed.

Imagine the scene: Your previously healthy husband has just collapsed at the dinner table. You frantically call 911. The EMTs show up and declare him dead on the spot. Nothing they can do for him. Sorry ma'am. You are in shock, hardly even able to take in what has happened. Suddenly, entirely uninvited, a whole additional team of complete strangers shows up at your home. They start trying to comfort you, and you try, in your state of shock, to figure out who all these people are. Then they start asking you whether your husband was signed up to be an organ donor. You don't know. Not that you know of. The two of you really hadn't talked about the matter. Look, you ask, is it true? Is he really dead? Can't anything be done? No, ma'am, no ma'am. He's been declared dead. Now, about those organs. Our computer records show that he is listed as being on the registry. He could give the gift of life to someone else. Do we have your permission? Can we take the body? There isn't much time, you see, to get this done. Just sign here, ma'am...

And off they go with his body, in some haste, to get the kidneys.

This is almost beyond comprehension. The vulture-like circling around when a person is overheard to be in danger of dying. The blatant invasion of privacy in coming uninvited to the home of a person who has just collapsed. The unexpected, intense pressure on relatives at the time immediately after a loved one has suddenly died. The short-circuiting of the grieving process. The hasty removal of the body from shocked and grieving relatives. The lack of professionalism in requiring a single police detective to make a rapid decision about whether the body is needed for an investigation. The list of violations of privacy, basic human decency, and professional behavior just goes on and on.

In case you're wondering how this can not be a violation of strict federal laws about giving out private information (how much more private can, "Mr. So-and-so at the following address has just this minute collapsed and may be dead of heart failure" be?), here's how they apparently will be able to get around that, based on my own brief research: EMTs and 911 dispatchers are, understandably, permitted to give out private information over the radio waves for purposes of helping and treating the person in need. If someone else listens in, this is considered an "incidental disclosure," so no one is liable for the release of private information. By getting a good radio scanner, the body snatchers in Manhattan intend quite deliberately to exploit these "incidental disclosures" for purposes that have nothing whatsoever to do with treating the patient (remember the patient?) for whose sake the 911 call has been made.

This absolutely must be outlawed in New York, and such programs absolutely must not be allowed to spread to other locations. In my local community, one technically has to have a permit to come to homes unsolicited to sell magazines. How much more should people be disallowed from coming to your door unsolicited to try to obtain your loved one's internal organs?

Federal funding for such programs must be outlawed by Congress. And the legislature of New York State should immediately pass a law something like the following:

It shall be a [fill in class of offense here] to approach a private residence, apartment, or nursing home facility for purposes of soliciting or obtaining organs for transplant from any person present at, residing in, or recently deceased at said private residence, apartment, or nursing home facility. [Insert penalties here.]

That's it. It's bad enough that relatives can be dinned for the organs of their loved ones who are dying in hospitals. Let's at least leave the families alone whose loved ones die at home.

Oh, and if some distraught, shocked, husband happens to assault one of the Manhattan body snatchers...I more than half hope he doesn't get arrested.

Comments (16)

Yeah...There's always a tension involved in organ donation. The same theme keeps coming up; what if there is a mistake or my loved one is not really dead? We know that occasionally even highly skilled professionals have had patients that were deemed unsalvageable later recover. Because my job occasionally involves clinical assessment for donation I honestly doubt the whole 'transplant team as vultures' scenario. In my experience we have never gone looking for organs.
However; this story brings up an excellent point. By harvesting the kidneys earlier and more aggressively no doubt the there will be more successful transplants, but if even well meaning conscientious well trained professionals in a hospital setting (best case) are wrong in predicting outcomes, paramedics doing a rapid assessment on the scene sounds downright dangerous to me. I'd be tempted to remove my name from the registry in that state, and maybe write the powers-that-be and tell them why.
As our current knowledge and technology stand, and assuming the best possible efforts from the medical team, I don't think there's any way of completely guaranteeing that no recoverable patient will ever have their organs harvested. There are just to many variables, and to many unknowns about brain function and healing.
If one felt strongly enough about it they may wish to advocate discontinuance of transplants altogether, but remember that even on a good day, almost all medical procedures care some risk.

>> I honestly doubt the whole 'transplant team as vultures' scenario … even on a good day, almost all medical procedures care some risk.

But even aside from making mistakes of that sort, there are still things to worry about. I think the most fundamental worry is what it does to life generally. If I participate in the organ transplantation industry, do I make it more likely that others will die an undignified death surrounded by strangers? Is it more likely that persons will be seen more as objects?

BTW, I met a dialysis tech recently who said he's seen patients go through seven kidneys -all rejected. I wonder if we are largely in the dark about what really goes on in this industry.

Because my job occasionally involves clinical assessment for donation I honestly doubt the whole 'transplant team as vultures' scenario.

I don't know quite what you mean, James. The scenario is what it is. They are going to behave as described in the main post. This means they are literally going to listen in on 911 calls and start the process in motion when someone is in danger of dying. Remember, this is Manhattan. They have to think about traffic. They won't knock on the door until the person is declared dead, but the whole "hey, maybe this is one for us" thing is going to be kicked off by learning that someone might be about to die of cardiac arrest or might just have died of cardiac arrest. I _call_ that vulture-like. There's nothing new to learn here. If you don't think that's vulture-like behavior, that's your opinion.

Actually, I think it's pretty unlikely to result in transplantable organs. Fifty minutes is a long time. These organs are, I would guess, going to be less viable for transplant than those harvested in a carefully controlled environment in the hospital.

Wesley Smith suggests that this may be part of an overall campaign to move us toward presumed consent. Certainly the article does mention, without using the phrase, presumed consent in other countries. Presumed consent is becoming a cause among bioethicists, and there's no doubt that there are people who would like to see that legal scenario in the U.S.

I have to admit that it's difficult to know what the article means by saying that the program could be deemed a success even if not a single organ is successfully harvested. What in the world is that about? It does invite conjecture.

>> Actually, I think it's pretty unlikely to result in transplantable organs. Fifty minutes is a long time.

That was my initial thought too. Really? Then I read the article that said "the five-month trial ... could be declared a success without a single organ being recovered, organizers say."

A pilot project where the stated goal isn't necessarily required to be successful. So what is the real goal?

>> Wesley Smith suggests that this may be part of an overall campaign to move us toward presumed consent.

I would say he's right, along with a test of whether the public will accept all the ghoulish details that Lydia spelled out are implied in this project. If they can be convinced that all this is worth accepting to "give the gift of life" then it will be significant. I sure hope not.

See the short anecdote Jumping the Gun in Margaret Lock's "Twice Dead" on the problem of seeing persons as a parts container. It is inevitable, whatever other mistakes there may be.

To be more clear, in reading things like "Jumping the Gun" or transplantation generally, the discussion always turns to how to minimize mistakes. The thinking goes that if only we could minimize mistakes everything would be well. Our courts make mistakes, and this doesn't invalidate our justice system. Likewise, mistakes wouldn't invalidate the organ donation industry. But I'm dubious that this is a valid analogy and that organ donation is no more morally problematic than that. Seeing humans as objects I think is an inevitable result. I'm not saying that it should not be done, surely at least paired organs are much less morally problematic, but thinking it morally unproblematic generally is incorrect.

Here one can easily make a similar argument that Catholics do about "reproductive technology". It might not be popular, but I think we are unwise to ignore it. I would like to think that I'd have the courage (if that's what it is, though I'm not sure because I'm not sure transplantation is as successful as advertised all considered) to just cash out if my organs give out rather than participate in a system that undignifies death and advances an ugliness that makes life less valuable for those that come after me.

The line between organ harvesting and cannibalism is blurred in my mind.

Interesting that you should say that, Thomas. I made the argument for a prima facie ethical similarity between them at the old Right Reason.

It's always difficult to know whether and how to bring that up when I put up a post like this. Even if someone thinks that organ harvesting could at least in principle be ethical, these sorts of programs should make people wonder whether that "in principle" is what's being done in practice. So I often try to post these stories without saying anything about my worries about the entire enterprise of vital organ harvesting in the hopes that at least people will rise up and oppose the particular atrocity in question.

On the other hand, I also wonder whether this might be like IVF: The more ghoulish and blatantly unethical the actual practices become, the more people have an opportunity to backtrack and ask themselves whether there might have been something wrong at the heart of the matter from the beginning--in both cases, it seems to have something to do with commodifying human beings.

Hey Lydia, thanks for your comments. The transplants I've been involved in have never been anywhere nearly this aggressive; organ donation has always taken second place to the donor patient and their survival; only when this hope appears to be exhausted do we start to think about transplants. Clearly that’s not the case here, and you are right, this proposal takes transplantation to a whole new level.
My main point was actually that the risk of accidently harvesting from a viable patient is likely compounded in this scenario. I wasn't really commenting on the morality of transplantation itself.
I started off my career just assuming that transplantation was a natural extension of medicine, but over the years I've come to doubt the conventional wisdom on this subject. And I wasn't being facetious in the my last paragraph; I really do believe that advocating the discontinuance of transplantation is a supportable intellectual position.
Transplant teams can you lots of true "happy ending" stories, where even the patients family felt better, and the sector of "meaningless death" was at least temporarily warded off by this "final act of generosity", but your comments to Thomas are basically spot on, there is in fact something very questionable at the heart-of-the-matter. My body and soul recoil at the idea of transplantation ever being applied to me, and if I needed a transplant to live I wouldn’t pursue it. Especially for the Christian there are worse things than death.
Pax James

I think that if they really waited an entire fifty minutes after declaration of death by cardiopulmonary criteria, with no CPR during that time, then there would be no further risk that the person was really revivable. (And by the same token, there would be a lower probability that the organs would be usable anyway.) But of course fifty minutes is the outside time. If they came and got permission really quickly, then the possibility that the patient could have been revived is much higher. So I agree with you there.

It's interesting to me at any rate to see that this scenario, where the danger that the patient is really alive may be very low (on the fifty minute end of the time spectrum) has so many other problems--namely, the invasion of the home and privacy and the callous treatment of the family. It just seems that there's always something really, really problematic about organ transplant.

It's interesting what you say about the specter of meaningless death. I worry a little bit about what that means: It's almost like the families you describe are attaching a religious significance to the organ transplant, because they have nothing else to give significance to death and no other hope of eternal life. And in fact I've seen discussions of transplant that seem to do this: "He lives on." "His heart lives on," etc. Transplant _shouldn't_ have a religious significance, I think. It's not true immortality, of course. Something almost pagan there in the family's attitude.

"I don't think there's any way of completely guaranteeing that no recoverable patient will ever have their organs harvested"

James, I'm not familiar with medical terminology. When you say "no recoverable patient" do you mean a patient who was mistakenly declared dead or are you saying that organs are harvested while patients are still alive but not considered "recoverable"?

I've got a student who lives his life now in a wheelchair, after being paralyzed in a horrific street-racing accident. He was dead in the ambulance and declared so at the hospital. He remained that way for over an hour until a nurse happened to glance at his body and see movement. A hand twitched or something. Today, he spends his time trying to bring homeless people and "at-risk" youth to Jesus, and makes his living trading stocks online.

Anyway, I foresee problems with the Manhattan policy. And one cannot help but wonder if the zeal for sustaining life in those in need of organs gives rise to an unacknowledged, parallel disdain for the lives of those who will be supplying them.

You have a good point, Bill, about the possible pitfalls of the type of death declaration likely to be done here--subject to error, that is to say.

It's _certainly_ true that the zeal for helping those who need organs gives rise to a disdain for the lives of donors. And the reason isn't far to seek: Potential donors are assumed to be "on their way out" whereas potential recipients are deemed to have years of life ahead of them, etc.

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